Women with obesity report more menopausal symptoms, less relief with HT
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Key takeaways :
- Almost 75% of women with obesity reported menopausal vasomotor symptoms vs. 45% of those without obesity.
- Women with obesity were less likely than those without to report symptom relief with any therapy.
PHILADELPHIA — In a small study, more women with obesity reported vasomotor, genitourinary, mood and libido symptoms associated with menopause than their peers without obesity, according to a presenter.
In addition, women with obesity reported less relief of menopausal symptoms with either systemic or local hormone therapy, Anita Pershad, MD, a resident in the department of obstetrics and gynecology at Eastern Virginia Medical School, said during her presentation at the Annual Meeting of The Menopause Society.
“Obesity may worsen a woman’s menopausal symptoms and limit the amount of relief she gets from hormone therapy,” Pershad told Healio. “Given that more than 40% of women over the age of 40 are classified as obese according to the CDC, these results could be meaningful to a large percentage of female patients transitioning through menopause.”
Pershad and colleagues reviewed medical records from 119 women — 72 with BMI at least 30 kg/m2 — who presented from July 2018 to December 2022 at a menopause clinic at an urban, academic medical center in the Mid-South. There were no significant differences between women with and without obesity in terms of age (mean age, 56.5 years and 54.6 years, respectively), menopausal stage, age since menopause or therapies prescribed. However, 71% of Black women in the study had obesity whereas 40% of white women did.
Significant differences were observed in symptoms. More women with obesity than without obesity reported vasomotor symptoms such as hot flushes and night sweats (74% vs. 45%; P = .002), genitourinary or vulvovaginal symptoms (60% vs. 21%; P .001), mood disturbances such as anxiety and depression (11% vs. 0%; P = .018) and decreased libido (29% vs. 11%; P = .017).
Women with obesity were less likely than those without obesity to report attaining relief with any therapy (OR = 0.07; 95% CI, 0.01-0.64; P = .006). Of the 12 women with obesity prescribed systemic HT, one (8.3%) reported improvement in symptoms, whereas seven of the eight women without obesity (88%) said symptoms improved. Localized HT was associated with self-reported symptom improvement for 11 of 24 (46%) women with obesity and eight of nine (89%) women without obesity. Of those using nonhormonal therapies, such as antidepressant agents, 15 of 20 women with obesity (75%) and 10 of 13 (77%) without obesity said their symptoms improved. Of those using only lifestyle modification, five of 16 women with obesity (31%) and 10 of 17 without (59%) reported improved symptoms.
“We studied menopausal symptoms in an underrepresented patient population, not often included in women’s health studies,” Pershad told Healio. “This research can help clinicians serving a more diverse racial and socioeconomic patient population, severely affected by the social determinants of health, to provide better tailored care and counseling to patients seeking treatment for their menopausal symptoms.”